Kristina Marie Prus, M.D.

Primary specialty

Blood Banking & Transfusion Medicine PhysicianTaxonomy code 207ZB0001X

License

MD206562 Issued in OR

Practice address

3131 N Vancouver Ave
Portland, OR 97227-1596

Phone

(503) 528-5920

NPI assigned

Apr 14, 2014

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in OH

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Children'S Hospital Medical Center

  • Pediatrics Physician
  • Cincinnati, OH
  • NPI 1609915784
  Medicare reassignment NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1397433600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1629763200000",
    "number": "1174942585",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3131 N VANCOUVER AVE",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972271596",
            "telephone_number": "503-528-5920"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3131 N VANCOUVER AVE",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972271596",
            "telephone_number": "503-528-5920"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PRUS",
        "first_name": "KRISTINA",
        "middle_name": "MARIE",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-04-14",
        "last_updated": "2021-08-24",
        "certification_date": "2021-08-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080P0207X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Hematology-Oncology",
            "state": "OR",
            "license": "MD206562",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207ZB0001X",
            "taxonomy_group": "",
            "desc": "Pathology, Blood Banking & Transfusion Medicine",
            "state": "OR",
            "license": "MD206562",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Andre B Pruitt, PH.D., MSW
• Joseph David Pruitt
• Genevieve Pruneau, PHD
• Jennifer Carol Prunty, O.D.
• William J Prunty, OD
• Rachel Beth Prusak, FNP
• Kara Prussing, MD
• Brian Paul Prusynski
• Paul Prusynski
• Jennifer Ann Pryal

• Blood Banking & Transfusion Medicine Physician in Portland, OR
• Providers in Portland, OR by specialty
• Blood Banking & Transfusion Medicine Physician in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 24, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.